Are You up for the Challenge?

Take the Daily Dozen Challenge

Today we are launching a Daily Dozen Challenge to help more people discover how easy it is to fit some of the healthiest of healthy foods into their daily routine. I’m kicking it off by publicly challenging three of my friends and you to try to check off all the Daily Dozen servings for one day (based on my Daily Dozen checklist).

Watch the kickoff video here. Then you challenge more people, and on and on, and soon lots of people will be eating healthy! 

Join me by:

  1. Accepting the challenge: Pick a day to eat the Daily Dozen, and then release your own public announcement asking others to do it.
  2. Posting a picture or video about your experience and tagging 3 more people to challenge them: Use the hashtags #HowNotToDie and #DailyDozenChallenge in your announcement post and ask others to do the same. Let people know they can track their Daily Dozen on our free iPhone and Android apps. You can challenge 3 people personally, or ask all of your friends!
  3. If you or your “challengees” are unable to complete the Daily Dozen challenge you can ask them to consider donating $12 to help spread this life-changing life-saving info to others.

If you don’t have it yet, my new cookbook has tons of green-light recipes to help reach the Daily Dozen (all of the proceeds from my books go to charity). My neat new video on The Daily Dozen is going live on NutritionFacts.org tomorrow, March 30th, but you can catch it early on our YouTube channel

As we roll out this challenge, keep an eye on our social media pages where we will be doing contests for books, shirts, and even the beautiful Daily Dozen poster

 

 

Get the App

Just in time for the Daily Dozen Challenge, we released our totally updated iPhone app! Those of you on Android have had all these nifty features, and now our iPhone users can check out the updates here, which include the option to track your progress over multiple days and enable a daily reminder to record your items.

We are honored that the app was recently featured as an iTunes app-of-the-day, which you can read about here.

 

Now Hiring!

Thanks to an incredibly kind donation from John and Jeanne Esler, we’re excited to be able to open up a new position at NutritionFacts.org. We’re looking for an experienced Media and Events Director to enhance our global reach and manage my speaking tours. Job description and application are here.

 

 

Get Our Best-Selling Hoodie

You’ve asked for it, and here it is: Our Plants Are the Best Medicine was a best-seller in our fundraising campaign last year, and now it’s available year-round in the store. As always, all proceeds go to keeping NutritionFacts.org alive and thriving.  

 

 

 

 

 

Comments on USDA Dietary Guidelines

I’m excited to share this press release—hot off the press from the American College of Lifestyle Medicine. As a founding member and fellow of ACLM, I’m asking all NutritionFacts.org followers to join ACLM’s call for participation to help shape our U.S. Dietary Guidelines! The deadline to submit a comment is tomorrow, March 30th.

 

NutritionFacts.org en Español 

Recuerda que NutritionFacts.org ya está disponible en español, ¡tenemos videos y blogs traducidos para ti gratuitamente! puedes visitarnos aquí.

Asegúrate de suscribirte a nuestro boletín para tener nuestros videos y blogs directamente en tu correo y síguenos en nuestras redes sociales: 

 

  • Facebook: NutritionFactsEspanol
  • Instagram: @nutritionfactsespanol
  • Twitter: @NF_Espanol

 

One Night Only

Eating You Alive, the documentary which dramatically shows reversal of chronic disease, will be screened in approximately 600 theaters across the country for a one night special event on April 5th. This will be the largest theatrical exhibition of a plant-based film in history and we invite you to be a part of it.  See if it’s playing in your town: https://www.eatingyoualive.com/

 

Live Q&As

Every month I do Q&As live from my treadmill, and April 26th is the next one.

  • Facebook Live: At 1:00 p.m. ET April 26th, go to our Facebook page to watch live and ask questions.
  • YouTube Live Stream: At 2:00 p.m. ET April 26th go here to watch live and ask even more questions! 

You can now find links to all of my past live YouTube and Facebook Q&As right here on NutritionFacts.org. If that’s not enough, remember I have an audio podcast to keep you company at http://nutritionfacts.org/audio.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

The Risks and Benefits of Calcium Supplements

There has been an assumption for decades that as a natural element, calcium supplements must intrinsically be safe. But, as I explore in my video Are Calcium Supplements Effective?, calcium supplementation is neither natural nor risk-free. The same could be said, however, for all medications, yet doctors continue to write billions of drug prescriptions every year hoping the benefits outweigh the risks.

So, what about the benefits of calcium supplements versus the risks they pose for heart attacks and strokes? Having a heart attack or stroke can be devastating, but so can a hip fracture. In the months after a hip fracture, risk of dying shoots up, with about one in five women passing away within a year. The odds are even worse for men, with hip fractures having the potential to shorten lifespan by an average of four or five years. Unfortunately, these dismal statistics haven’t been getting much better.

Even if calcium supplements caused a few heart attacks and strokes, it could be argued that if they prevented many more hip fractures, then the risk-benefit ratio might be favorable. But how effective are calcium supplements in preventing hip fractures? We’ve known that milk intake doesn’t appear to help, but maybe that’s because any potential benefit of the calcium in milk may be overshadowed by the increased risk of fracture and death associated with the galactose sugar in milk. (See Is Milk Good for Our Bones? for more on this.) Then what about the calcium in a calcium supplement alone? Calcium intake in general does not seem to be related to hip fracture risk at all. When people have been given calcium supplements, they saw no reduction in hip fracture risk but rather an increased risk was possible. In fact, the randomized controlled trials suggested a 64 percent greater risk of hip fractures with calcium supplementation, compared to a placebo sugar pill.

So where did we get the idea that taking calcium supplements might help our bones? An influential 1992 study found that a combination of vitamin D and calcium supplements could reduce hip fracture rates by 43 percent. However, the subjects in the study were institutionalized women, living in places like nursing homes, who were vitamin D deficient. They weren’t getting sufficient sun exposure. So, if you’re vitamin D deficient and then you take vitamin D and calcium, it’s no surprise your bones get better.

For postmenopausal women living independently in the community, the latest official recommendation for calcium and vitamin D supplementation to prevent osteoporosis is unambiguous: We should not supplement. Why? Because “[i]n the absence of compelling evidence of benefit, taking supplements is not worth any risk, however small.” This is not to say that these supplements don’t play a role in treating osteoporosis or that vitamin D supplements might not be good for other things. But, if you’re just trying to prevent fractures, women living outside of institutions should not take them—and this might even apply to those who live within them.

In a 2012 study, instead of giving nursing home residents vitamin D and calcium supplements, researchers randomized them so one group received sunlight exposure and the other took calcium supplements. Those in the calcium pill group had significantly increased mortality, living shorter lives than those in the sunshine group.

Although calcium supplements don’t appear to prevent hip fractures, they may reduce overall fracture risk by approximately 10 percent. If you’re wondering whether this means it could be worth taking them, here’s how the risk-benefit shakes out: If 1,000 people took calcium supplements for five years, we would expect 14 excess heart attacks—that is, 14 people having heart attacks who would not have had heart attacks if they hadn’t started taking the calcium supplements. They were effectively going to the store and buying something that gave them a heart attack. We also would expect 10 strokes and 13 deaths that otherwise would not have happened. An expected 14 heart attacks, 10 strokes, and 13 deaths compared with preventing only 26 fractures. Of course, it’s no fun falling down and breaking your wrist, but most people would probably look at the risk-benefit analysis and conclude that calcium supplements are doing more harm than good.

Dietary calcium, on the other hand, has not been associated with an elevated risk of heart attacks. Given these findings, individuals should be discouraged from taking calcium supplements and advised to obtain calcium from their diet instead. How much dietary calcium should we shoot for then?

Interestingly, unlike most other nutrients, there’s not an international consensus on how much to take. For example, in the United Kingdom, the recommendation for adults is 700 mg per day. Across the pond in the United States, it’s up to 1,200 mg per day. Whenever I see that kind of huge discrepancy between government panels, I immediately think scientific uncertainty, political maneuverings, or both.

Newer data based on calcium balance studies where researchers made detailed measurements of the calcium going in and out of people suggest that the calcium requirements for men and women are lower than previously estimated. They found that calcium balance was highly resistant to change across a broad range of intakes, meaning our body is not stupid. If we eat less calcium, our body absorbs more and excretes less. And if we eat more calcium, we absorb less and excrete more to stay in balance.

Therefore, current evidence suggests that dietary calcium intake is not something most people need to worry about. This may explain why in most studies, no relationship has been found between calcium intake and bone loss anywhere in the skeleton because the body just seems to take care of it.

Don’t push it too far, though. Once you get down to just a few hundred mg per day, you may get significantly more bone loss. Though there may not be great evidence to support the U.S. recommendations, the United Kingdom may have the right idea shooting for 500 to 1,000 mg per day from dietary sources. This applies unless you’ve had gastric bypass surgery or have another reason for needing supplementation. For most people, though, calcium supplements cannot be considered comparatively safe or effective for preventing bone fractures. 


What’s this about calcium supplements and heart attacks and strokes? You can learn more about it in my Are Calcium Supplements Safe? video. And be sure to watch Should Pregnant Women Take Calcium Supplements to Lower Lead Levels? and Lead in Calcium Supplements

As mentioned above, for a more in-depth discussion on the milk-fracture relationship see my Is Milk Good for Our Bones? video.

All of this is not to say that these supplements cannot play any role in treating osteoporosis or that vitamin D supplements might not be good for other things. I do advise vitamin D supplementation for those not getting enough sun. (See my recommendations here.) For background on how I arrived at my recommended dose and more information on vitamin D, check out:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

If Calcium Supplements Aren’t Safe, What About Calcium in Food?

In 12 short years, government panels have gone from suggesting widespread calcium supplementation may be necessary to protect our bones to “do not supplement.” What happened? I explore this in my Are Calcium Supplements Safe? video.

It all started with a 2008 study in New Zealand. Short-term studies have shown that calcium supplementation may drop blood pressures by about a point. Though the effect appears to be transient, disappearing after a few months, it’s better than nothing. Further, excess calcium in the gut can cause fat malabsorption by forming soap fat, reducing saturated fat absorption, and increasing fecal saturated fat content. Indeed, if you take a couple Tums along with your half bucket of KFC, up to twice as much fat could end up in your stool. With less saturated fat absorbed into your system, your cholesterol might drop. Given this, the New Zealand researchers were expecting to lower heart attack rates by giving women calcium supplements. To the researchers’ surprise, however, there appeared to be more heart attacks in the calcium supplement group.

Was this just a fluke? All eyes turned to the Women’s Health Initiative, the largest and longest randomized, controlled trial of calcium supplementation. The name may sound familiar—it’s the same study that uncovered how dangerous hormone replacement therapy is. Would it uncover the same for calcium supplements? The Women’s Health Initiative reported no adverse effects. However, the majority of the participants were already taking calcium supplements before the study started. So, effectively, the study was just comparing higher versus lower doses of calcium supplementation rather than supplementation versus no supplementation. What if you go back and see what happened to the women who started out not taking supplements and then were randomized to the supplement group? Those who started calcium supplements suffered significantly more heart attacks or strokes. Thus, high dose or low dose, any calcium supplementation seemed to increase cardiovascular disease risk.

Researchers went back, digging through other trial data for heart attack and stroke rates in women randomized to calcium supplements with or without vitamin D added, and they confirmed the danger. Most of the population studies agreed: users of calcium supplements tended to have increased rates of heart disease, stroke, and death.

The supplement industry was not happy, accusing researchers of relying in part on self-reported data—that is, simply asking if people had had a heart attack or not, rather than verifying it. In fact, long-term calcium supplementation causes all sorts of gastrointestinal distress, including twice the risk of being hospitalized with acute symptoms that may have been confused with a heart attack. However, the increased risk was seen consistently across the trials, regardless of whether the heart attacks were verified or not.

Okay, but why do calcium supplements increase heart attack risk, but the calcium you get in your diet doesn’t? Perhaps because when you take calcium pills, you get a spike of calcium in your bloodstream that you don’t get from just eating calcium-rich foods. Within hours of taking supplemental calcium, the calcium levels in the blood shoot up and can stay up for as long as eight hours. This evidently produces what’s called a hypercoagulable state. That is, your blood clots more easily, which could increase the risk of clots in the heart or brain. Indeed, higher calcium blood levels are tied to higher heart attack and stroke rates. So, the mechanism may be that calcium supplements lead to unnaturally large, rapid, and sustained calcium levels in the blood, which can have a variety of potentially problematic effects.

Calcium supplements have been “widely embraced…on the grounds that they are a natural and, therefore, safe way of preventing osteoporotic fractures.” However, it is now becoming clear that taking calcium in one or two daily doses is not natural, in that “it does not reproduce the same metabolic effects as calcium in food,” the way nature intended. Furthermore, the evidence is also becoming steadily stronger that calcium supplementation may not be safe. This is why most organizations providing advice regarding bone health, now “recommend that individuals should obtain their calcium requirement from diet in preference to supplements.”


We actually evolved getting lots of calcium—from eating lots of green leafy weeds, not popping Tums. See Paleolithic Lessons for more on this. How else can we combat osteoporosis? See my videos Prunes for Osteoporosis and Almonds for Osteoporosis.

I’ve discussed whether calcium supplements are safe, but Are Calcium Supplements Effective?

For more on calcium and bone health, see my videos:

Calcium supplements aren’t alone in their lack of efficacy. It is a story consistent with disappointments surrounding many other supplements, which you can learn more about in the following videos:

And be sure to watch Should Pregnant Women Take Calcium Supplements to Lower Lead Levels? and Lead in Calcium Supplements

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: